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Journal of Pain & Palliative Care Pharmacotherapy

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https://www.readbyqxmd.com/read/28506099/propofol-based-palliative-sedation-to-treat-antipsychotic-resistant-agitated-delirium
#1
Alfredo Covarrubias-Gómez, Maria López Collada-Estrada
Delirium is a common problem in terminally ill patients that is associated with significant distress and, hence, considered a palliative care emergency. The three subtypes of delirium are hyperactive, hypoactive, and mixed, depending on the level of psychomotor activity and arousal disturbance. When agitated delirium becomes refractory in the setting of imminent dying, the agitation may be so severe that palliative sedation (PS) is required. Palliative sedation involves the administration of sedative medications with the purpose of reducing level of consciousness for patients with refractory suffering in the setting of a terminal illness...
May 16, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28489478/continuous-intravenous-lidocaine-infusion-for-the-management-of-pain-uncontrolled-by-opioid-medications
#2
David J Reeves, Alexandra E Foster
Limited data exist describing the outcomes of patients receiving continuous lidocaine infusions. The objective of this study was to evaluate the effect of use of continuous lidocaine infusions for pain management at a community teaching hospital. A retrospective chart review was performed that included adult patients receiving continuous systemic lidocaine infusions for the treatment of pain. Twenty-one patients were included in the analysis. Dosing ranged from 0.25 to 2.8 mg/kg/h, with a median infusion time of 64 hours...
May 10, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28489476/benefits-of-thoracic-epidural-analgesia-in-patients-undergoing-an-open-posterior-component-separation-for-abdominal-herniorrhaphy
#3
Daryl S Henshaw, Christopher J Edwards, Austin R Sellers, Gregory B Russell, Robert S Weller
An open posterior component separation (PCS) is a commonly utilized surgical approach for repair of complex abdominal wall defects and hernias. Although this approach may improve surgical outcomes, significant postoperative pain can be expected given the required laparotomy and extensive abdominal wall manipulation. Both systemic opioids and thoracic epidural analgesia (TEA) are viable postoperative analgesic options, and both are commonly utilized. Although the benefits of TEA have been investigated following a variety of surgeries, there is a paucity of literature related to its efficacy for this particular surgery...
May 10, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28644751/medical-cannabis-for-pain-anecdote-or-evidence
#4
Arthur G Lipman
No abstract text is available yet for this article.
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28644749/breakfast-lunch-and-dinner
#5
(no author information available yet)
No abstract text is available yet for this article.
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28644748/paediatric-palliative-medicine-2nd-ed
#6
Roger Woodruff
Editor's Note The journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28644747/pain-management-and-prescription-opioid-related-harms-exploring-the-state-of-the-evidence-proceedings-of-a-workshop-in-brief
#7
Arthur G Lipman
No abstract text is available yet for this article.
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28644746/conversations-on-dying-a-palliative-care-pioneer-faces-his-own-death
#8
Roger Woodruff
Editor's Note The journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28569616/doctor-related-medication-safety-incidents-on-a-specialist-palliative-medicine-inpatient-unit-a-retrospective-analysis-of-three-years-of-voluntary-reporting
#9
Hannah O'Brien, Fiona Kiely, Ann Carmichael
Patients receiving palliative care and those at the end of life are known to be susceptible to medical errors. Errors related to medications are the most avoidable cause of patient harm. This retrospective study examined reported anonymized medication safety incidents, related to physician errors, assessed by the risk committee in a specialist palliative care unit over a 3-year time period. The aim of the study was to describe medication errors, with specific attention paid to what type of errors occurred and when these errors happened...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28521551/systematic-reviews-published-in-the-cochrane-library-january-march-2017
#10
Phillip J Wiffen
The Cochrane Library of Systematic Reviews is now only published monthly online ( http://www.thecochranelibrary.com ). The methods for searching have changed and are in flux. This report attempted to identify all relevant reviews published in the last 3 months to March 30, 2017. The current version contains 7243 complete reviews and 2544 protocols for reviews in production. In addition, there are citations of 1,036,153 randomized controlled trials (first time passing the million mark) and 15,700 cited papers in the Cochrane Methodology Register...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28506184/complications-of-psychotropic-and-pain-medications-in-an-ultrarapid-metabolizer-patient-at-the-upper-1-of-cytochrome-p450-cyp450-function-quantified-by-combinatorial-cyp450-genotyping
#11
Gualberto Ruaño, Karen Larsen, Mohan Kocherla, James Samuel Graydon, Jonathan Kost
A 44-year-old Caucasian woman presented with a history of empirical treatment with 20 pain and psychotropic medications, as well as dual comorbidity of intractable pain and depression. A multiple gain-of-function profile in the CYP450 family of cytochrome P450 (CYP450) drug metabolism isoenzymes was discovered. The patient was a homozygote of suprafunctional alleles for both CYP2D6 ((*)35/(*)35) and CYP2C19 ((*)17/(*)17) genes and functional alleles for CYP2C9 ((*)1/(*)1), which account for aggregate drug metabolism function at the upper 1% of the population...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28489477/combined-sciatic-and-lumbar-plexus-nerve-blocks-for-the-analgesic-management-of-hip-arthroscopy-procedures-a-retrospective-review
#12
J Douglas Jaffe, Theodore Ross Morgan, Gregory B Russell
Hip arthroscopy is a minimally invasive alternative to open hip surgery. Despite its minimally invasive nature, there can still be significant reported pain following these procedures. The impact of combined sciatic and lumbar plexus nerve blocks on postoperative pain scores and opioid consumption in patients undergoing hip arthroscopy was investigated. A retrospective analysis of 176 patients revealed that compared with patients with no preoperative peripheral nerve block, significant reductions in pain scores to 24 hours were reported and decreased opioid consumption during the post anesthesia care unit (PACU) stay was recorded; no significant differences in opioid consumption out to 24 hours were discovered...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28489466/intrathecal-injection-of-gadobutrol-a-tale-of-caution
#13
Corey Reeves, Enrique Galang, Raj Padalia, Nam Tran, Devang Padalia
In the field of interventional pain medicine a radiocontrast agent is commonly used in conjunction with fluoroscopy. Limited work has been published regarding the use of gadolium based contrast agents (GBCA) in the intrathecal space. We report a case of an intrathecal gadobutrol injection resulting in neurotoxic manifestations.A 60-year-old female with a history significant for lumbar post-laminectomy syndrome and intrathecal drug delivery implantation was admitted for lumbar fusion and kyphoplasty. Postoperatively, the patient had escalating pain medication requirements...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28436710/ischemic-ulcer-pain-is-both-nociceptive-and-neuropathic-pain-based-on-a-discriminant-function-analysis-using-the-mcgill-pain-questionnaire
#14
Takamichi Kogure, Masahiko Sumitani, Hiroaki Abe, Jun Hozumi, Reo Inoue, Kazuhito Mietani, Kazuo Kawahara, Yoshitsugu Yamada
The McGill Pain Questionnaire (MPQ) is composed of 78 words reflecting the mechanisms underlying chronic pain conditions. Ischemic ulcer pain is generally regarded as a nociceptive and inflammatory pain condition. However, it is sometimes refractory to nonsteroidal anti-inflammatory drug (NSAID) and opioid treatment. We categorized ischemic pain into nociceptive/inflammatory pain (NocP) or neuropathic pain (NeP), on the basis of patients' descriptions of their pain using the MPQ. We investigated pain characteristics of 365 patients with NeP and 124 with NocP using the 78 words of the MPQ...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28388238/oral-versus-topical-diclofenac-sodium-in-the-treatment-of-osteoarthritis
#15
Vinicius Tieppo Francio, Saeid Davani, Chris Towery, Tony L Brown
Osteoarthritis (OA) is one of the most common causes of joint pain in the United States and non-steroidal anti-inflammatories (NSAIDs), such as Diclofenac sodium, which is currently available in two main routes of administration; oral and topical distribution have been established as one of the standard treatments for OA. Generally, oral NSAIDs are well tolerated; however our narrative review suggests that the topical solution had a better tolerability property than oral Diclofenac sodium, especially due to side effects of gastrointestinal bleeding with the utilization of the oral format...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28379050/pathophysiology-of-trigger-points-in-myofascial-pain-syndrome
#16
Sarah Money
Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. Trigger point pathophysiology in myofascial pain syndrome, which involves muscle stiffness, tenderness, and pain that radiates to other areas of the body, is considered. The causes of trigger points and several theories about how they develop are reviewed, and treatment approaches, including stretching, physical therapy, dry needling, and injections, are offered...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28375794/the-risks-of-chronic-corticosteroid-exposure
#17
Sarah Money
Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. This article focuses on the use of corticosteroids to decrease inflammation and treat painful conditions as well as their long-term side effects and risks. Their long-term use can expose the body to side effects and can cause long-term health concerns. It therefore is important to be aware of the risks of long-term corticosteroid use...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28375661/pain-management-of-malignant-psoas-syndrome-under-epidural-analgesia-during-palliative-radiotherapy
#18
Takayo Ota, Masaru Makihara, Hiroshi Tsukuda, Ryuji Kajikawa, Masayuki Inamori, Nozomi Miyatake, Noriko Tanaka, Masahiro Tokunaga, Yoshikazu Hasegawa, Takuhito Tada, Masahiro Fukuoka
Malignant psoas syndrome is a rare malignant condition presenting as lumbosacral plexopathy and painful fixed flexion of the hip. Metastasis to the psoas muscle is observed, which damages the nerve bundles in the lumbosacral plexuses. The syndrome presents as refractory lower back pain with several other neurological symptoms. The pain is difficult to control because it is a mixture of nociceptive and neuropathic pain, which indicates that treatment requires a versatile approach. The authors report a case of severe back pain caused by metastasis to the psoas muscle of advanced gastric cancer in a patient who underwent palliative radiotherapy under epidural analgesia...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28358257/effectiveness-of-corticosteroid-monotherapy-for-dyspnea-relief-in-patients-with-terminal-cancer
#19
Tsuyoshi Maeda, Toru Hayakawa
Dyspnea is a common symptom in patients with cancer, particularly those with late-stage terminal disease. It markedly affects terminal cancer patients, reducing their quality of life. Reduced quality of life also affects survival; therefore, dyspnea is a prognostic factor. However, the role of corticosteroids, which often are used to alleviate dyspnea, has not been sufficiently validated. In this study, we retrospectively investigated whether corticosteroid monotherapy was effective for dyspnea palliation. The effectiveness rate of corticosteroid therapy was 45% in nine male and two female study subjects (mean age: 74...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28358229/intractable-acute-pain-related-to-fluoroquinolone-induced-peripheral-neuropathy
#20
Matthew Dukewich, Arash Danesh, Chiemeka Onyima, Anita Gupta
Fluoroquinolones are widely prescribed antibiotics, used for various infectious etiologies. These antibiotics carry the possibility of the serious adverse effect of peripheral neuropathy, with a true incidence not known owing to its rare existence. Recently, the Food and Drug Administration (FDA) has required alterations to drug labels to highlight this adverse effect of fluoroquinolones. This is a case report of a single patient at an inpatient neurology service at an urban academic medical center in the United States...
June 2017: Journal of Pain & Palliative Care Pharmacotherapy
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